• Title/Summary/Keyword: Multi-objectives

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Nurses Attitudes toward Death, Coping with Death and Understanding and Performance Regarding EOL Care: Focus on Nurses at ED, ICU and Oncology Department (임종 다빈도 부서 간호사의 죽음에 대한 태도 및 대처정도와 생애 말기환자 간호와의 관계 - 응급실, 중환자실, 종양내과 병동 간호사를 중심으로)

  • Seo, Min-Jeong;Kim, Jung Yeon;Kim, Sanghee;Lee, Tae Wha
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.108-117
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    • 2013
  • Purpose: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. Methods: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. Results: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). Conclusion: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.

Differentiation of Adductor-Type Spasmodic Dysphonia from Muscle Tension Dysphonia Using Spectrogram (스펙트로그램을 이용한 내전형 연축성 발성 장애와 근긴장성 발성 장애의 감별)

  • Noh, Seung Ho;Kim, So Yean;Cho, Jae Kyung;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.100-105
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    • 2017
  • Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

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Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea (흡연과 위암 발생의 관련성에 관한 지역사회 기반의 코호트 연구)

  • Kim, Yeon-Ju;Shin, Ae-Sun;Gwack, Jin;Jun, Jae-Kwan;Park, Sue-Kyung;Kang, Dae-Hee;Shin, Hai-Rim;Chang, Soung-Hoon;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.6
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    • pp.467-474
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    • 2007
  • Objectives : Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. Methods : The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Career Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using Cox#s proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. Results : Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09-fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer ($P_{trend}<0.01$). Conclusions : This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.

Reliability of a Questionnaire for Women's Reproductive History (여성의 출산력과 초경 및 폐경 연령에 대한 설문지의 신뢰도)

  • Ko, Kwang-Pil;Park, Sue-Kyung;Kim, Yeon-Ju;Bae, Ji-Suk;Jun, Jae-Kwan;Gwack, Jin;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.181-185
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    • 2008
  • Objectives : This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. Materials and Methods: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. Results : The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. Conclusions : The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.

Current Status of Systems Biology in Traditional Chinese medicine - in regards to influences to Korean Medicine (최근 중의학에서 시스템생물학의 발전 현황 - 한의학에 미치는 영향 및 시사점을 중심으로 -)

  • Lee, Seungeun;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.1-13
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    • 2017
  • Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

Development of an Automated Measurement System for Dilution Process and Spraying Amount of Disinfectant

  • Kim, Jung-Chul;Chung, Sun-Ok;Cho, Byoung-Kwan;Chang, Hong-Hee;Kim, Suk;Chang, Dongil
    • Journal of Biosystems Engineering
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    • v.38 no.4
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    • pp.228-239
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    • 2013
  • Purpose: The objectives of this study were to develop an automated disinfectant dilution system, and an automated data management system for spraying amount for resolving uncertainty problem. Methods: Proper diluting rate was made by a controlled volume pump for liquid disinfectant and a screw conveyer pump for solid disinfectant. The water capacity of disinfecting system of 400 L was controlled by two water level sensors. The water quantity of water tank was controlled by the signals which were produced by the water level sensors. Signals were processed by Labview Programming, and ON/OFF of solenoid valve that was used for controlling water supplying to water tank, was controlled by SSR. The operating time of pumps for disinfectant was controlled quantitatively. A turbine flowmeter was used for development of automated measurement system for spraying amount of disinfectant. In order to save the flowmeter data and to control the spraying system, a multi-function data logger was used, and it was processed and saved in Excel file by a program developed in this study. Results: Labview 2010 was used for programming to control the automated measurement system for spraying amount of disinfectant. Results showed that the relationship between flowmeter value and time had a significant linear relationship such as 0.99 of $R^2$. Generally, 6.74 L/s of diluted disinfectant is sprayed for a vehicle passing through the disinfection system (about 15 seconds). Test results showed that average error between the measured spraying amount and the flowmeter data was 50 mL, and the range of error was 1.3%. Since the amount and time of spraying could be saved in real-time by using the spreadsheet files which could not be modified arbitrarily, it made possible to judge objectively whether the disinfection spraying was performed or not. Test results of spraying liquid and solid disinfectant showed that the errors between the measured discharge rate and the theoretical one were ranged within 3-4% for various dilution rates. Conclusions: The disinfection system developed would be working accurately. The automated spraying data base management system satisfied the purpose of this study. The automated dilution process system developed in this study could discharge liquid and solid disinfectant with accurate dilution rate, relatively.

The exposure of lead and cadmium and the dental caries (납 및 카드뮴의 노출과 치아우식증 발생요인과의 관련성)

  • Won, Young-Soon;Kwon, Ho-Jang;Rho, Sang-Chul;Chae, Yoo-Mi;Kim, Young-Soo;Bae, Kwang-Hak
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.4
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    • pp.695-705
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    • 2012
  • Objectives : The purpose of this study is to evaluate the appearance of having relationship between the exposure to lead and cadmium and the dental caries targeting adults in the Republic of Korea. Methods : The study was designed as a cross-sectional study, using the data of the Fourth Korea National Health and Nutrition Examination Survey. The subjects as 1,966 people, who were confirmed the appearance of dental caries among 1,991 people of having been offered the heavy-metal concentration in blood. Statistical analysis was conducted using SPSS 19.0, according to complex sampling design. Results : As a result of multi-variate analysis on factors of dental caries, in Model I without correction, the gender, age, educational level, appearance of lifelong smoking, daily toothbrushing frequency, appearance of using dental floss, and subjective oral health status were recognized as important factors. In Model II with correction of gender and age, the educational level, daily toothbrushing frequency, and subjective oral health status were recognized as statistically significant factors. In Model III with correction of all factors, the gender, age, educational level, appearance of using dental floss, and subjective oral health status were functioning as statistically significant factors. As a result of statistically analyzing relationship between the exposure to lead and cadmium and the dental caries targeting adults, it was analyzed that there is no significant correlation. However, in case of lead, the tendency of being grown the cross ratio of dental caries could be examined in model I, which didn't correct disturbance factor, model II, which corrected gender and age, and model III, which corrected all variables of disturbance factor. Conclusions : The exposure to lead and cadmium was indicated to have no relationship with adults' dental caries. However, a continuous research of relationship was considered to be necessary by using Korea National Health and Nutrition Examination Survey, which is surveyed in the future.

A Case Series of Survival Outcomes in Patients with Advanced-stage IIIb/IV Non-small-cell Lung Cancer Treated with HangAm-Plus

  • Bang, Sun-Hwi;Yoon, Jeung-Won;Cho, Chong-Kwan;Shin, Ji-Eun;Lee, Yeon-Weol;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.15 no.2
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    • pp.31-35
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    • 2012
  • Background and Objectives: Non-small-cell lung cancer (NSCLC) represents approximately 80% of all lung cancers. Unfortunately, at their time of diagnosis, most patients have advanced to unresectable disease with a very poor prognosis. The oriental herbal medicine HangAm-Plus (HAP) has been developed for antitumor purposes, and several previous studies have reported its therapeutic effects. In this study, the efficacy of HAP was evaluated as a third-line treatment for advanced-stage IIIb/IV NSCLC. Methods: The study involved six patients treated at the East- West Cancer Center (EWCC) from April 2010 to October 2011. Inoperable advanced-stage IIIb/IV NSCLC patients received 3,000 or 6,000 mg of HAP on a daily basis over a 12-week period. Computed tomography (CT) scans were obtained from the patients at the time of the initial administration and after 12 weeks of treatment. We observed and analyzed the patients overall survival (OS) and progression-free survival (PFS). Results: Of the six patients, three expired during the study, and the three remaining patients were alive as of October 31, 2011. The OS ranged from 234 to 512 days, with a median survival of 397 days and a one-year survival rate of 66.7%. In the 12-week-interval chest CT assessment, three patients showed stable disease (SD), and the other three showed progressive disease (PD). The PFS of patients ranged from 88 to 512 days, the median PFS being 96 days. Longer OS and PFS were correlated with SD. Although not directly comparable, the OS and the PFS of this study were greater than those of the docetaxel or the best supportive care group in other studies. Conclusion: HAP may prolong the OS and the PFS of inoperable stage IIIb/IV NSCLC patients without significant adverse effects. In the future, more controlled clinical trials with larger samples from multi-centers should be conducted to evaluate the efficacy and the safety of HAP.

Effect of values on major satisfaction in dental hygiene students (치위생(학)과 학생의 가치관이 전공만족도에 미치는 영향)

  • Kim, Mi-Na;Heo, Yun-Min;Kim, Hyoung-Joo;Ahn, Yong-Soon
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.1
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    • pp.81-89
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    • 2015
  • Objectives: The purpose of the study is to investigate the effect of values on major satisfaction in dental hygiene students. Methods: The subjects were 214 dental hygiene students in Seoul and Gyeonggi-do who filled out the self-reported questionnaire after receiving informed consents from January 20 to February 15, 2014. Except incomplete answers, 187 data were analyzed using PASW Statistics 18.0 for Scheffe post hoc test, Pearson correlation coefficient, hierarchical regression analysis, independent sample t-test, and one-way ANOVA. The questionnaire consisted of general characteristics of the subjects and values. General characteristics consisted of gender, age, grade, school record, major choice motivation, and the influencing person to choose the major. The instrument for values was modified from Shin based on MILOV(Multi-Item Measures Of Values) and two professors of dental hygiene verified the validity of the instrument. Instrument for values consisted of 7 questions of values for self-respect, 6 questions of relation oriented values, 5 questions of emotion oriented values, and 5 questions of values for others measured by Likert 5 scale. Cronbach's alpha was 0.769 in the study. The instrument for major satisfaction was modified from Na based on Program Evaluation Survey of Illinois University and two professors of dental hygiene verified the validity of the instrument. Major satisfaction consisted of 7 questions of general satisfaction, 5 questions of consciousness satisfaction, 5 questions of curriculum satisfaction and 3 questions of relation satisfaction measured by Likert 5 scale and Cronbach's alpha was 0.887 in the study. Results: Values of self-respect, relationship orientation and grade had significant influence on general satisfaction, while values of self-respect, relationship orientation and gender had significant influence on consciousness satisfaction. Values of relationship orientation, grade and school record had significant influence on curriculum satisfaction. Grade showed significant influence on relationship satisfaction. Conclusions: Values of self-respect and relationship orientation are the most important factors in dental hygiene students. The guidance for professional career and major satisfaction can be accomplished through the values of self-respect and relationship orientation.

A Case Study of Alumni Survey for Evaluation of Engineering Education Outcomes (공학교육 성과 평가를 위한 졸업생 설문조사 사례연구)

  • Hahn Song-Yop;Suh Kyung-Doug
    • Journal of Engineering Education Research
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    • v.5 no.1
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    • pp.34-49
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    • 2002
  • The School of Electrical Engineering and School of Civil, Urban, and Geosystem Engineering of Seoul National University (SNU) have conducted alumni surveys to evaluate the importance and preparedness of the engineering outcomes that are demanded in the industry and to feedback the survey results to the establishment of educational objectives and student capability and the revision of curricula. In this paper, first we analyzed the collected data to see the distributions of the respondents in terms of graduation year, profession, final degree, and so on. Second we evaluated the importance and preparedness of the engineering outcomes and compared them with those obtained at the Department of Mechanical and Aerospace Engineering of UCLA. The above-mentioned three groups gave very similar evaluation of the importance of each item of engineering outcomes, showing that the industry-demanding engineering outcomes are very similar regardless of country or major. Investigating the difference between the importance and preparedness, SNU showed relatively low preparedness compared to UCLA, meaning that SNU is somewhat behind UCLA in engineering education. On the other hand, all the three groups showed considerably poor preparedness in the abilities to function on multi-disciplinary teams and to communicate effectively, indicating that is needed education to strengthen these abilities.